Changes Of Upper Airway In Surgical And Non-surgical Treatment Of Skeletal Class ? Patients

The adult skeletal class ? malocclusion is a kind of common malocclusion in clinical practice.The patients usually have a typical "Crescent" profile,which has a serious impact on facial beauty.Moreover,such patients often have poor masticatory efficiency and dysphonia,which seriously affects the physical and mental development of patients.At present,there are two main methods for the treatment of skeletal Class ?malocclusion in adults without growth potential: 1.orthodontic camouflage;2.orthognathic surgery.Both of these methods may cause changes in the shape of the upper airway,which may lead to the occurrence of obstructive sleep apnea hypopnea syndrome(OSAHS),and the effect of the treatment of malocclusion on the upper airway has been the focus of interdisciplinary research.Objective: The purpose of this study is to compare the measurement indexes of upper airway before and after surgical and non-surgical in adult patients with skeletal class ?malocclusion,to understand the changes of upper airway before and after different treatment,to provide reference for clinical treatment plan of such patients,and to prevent the occurrence of iatrogenic OSAHS.Methods: 1.24 patients(9 males and 15 females)with skeletal Class ? malocclusion were collected,with an average age of 22.9 years(18-35 years);2.According to the treatment,they were divided into surgical group(BSSRO)10 cases and non-surgical group(orthodontic camouflage treatment)14 cases;3.The surgical group was taken X-ray cephalometric film before and 6 months after operation,and the non-surgical group was taken X-ray cephalometric film before and after treatment.Using the Dolphin 17.3 software,the measurement mark points and measurement items were selected for measurement;4.The paired t-test and independent sample t-test were conducted by SPSS17.0 to compare the changes of upper airway,hyoid bone and soft palate before and after the surgical and non-surgical.Results:1.In the surgical group,the sagittal diameter of the palatopharyngeal segment(U-MPW)of the upper airway decreased on average(2.25 ± 2.20 mm),the difference was statistically significant(P<0.05),the sagittal diameter of the glossopharyngeal segment(TB-TPPW)decreased on average(4.86±3.21mm),the difference was statistically significant(P<0.01),and there was no statistically significant difference in the other segments before and after treatment(P>0.05);The horizontal position of the hyoid(H-C4)retruded on average(5.10 ± 3.77mm),the difference was statistically significant(P<0.05);2.In the non-surgical group,the sagittal diameter of the glossopharyngeal segment(TB-TPPW)of the upper airway decreased on average(1.44±1.73),but the difference was not statistically significant(P=0.076),and there was no significant difference in other segments(P>0.05);3.In the surgical group,the sagittal diameter of the upper airway in the glossopharyngeal segment(TB-TPPW)before and after treatment was significantly greater than that in the non-surgical group,and the amount of hyoid bone retruded before and after the surgical group was also significantly greater than that in the non-surgical group,the difference was statistically significant(P<0.05).Conclusion:1.When BSSRO was used in adult patients with skeletal Class ? malocclusion,the sagittal diameter of the palatopharyngeal and glossopharyngeal segments of the upper airway had a significant narrowing trend,and the hyoid bone also had significant horizontal retrusio;2.In the treatment of orthodontic camouflage,the sagittal diameter of each segment of the upper airway did not change significantly in adult patients with skeletal Class ? malocclusion,but the glossopharyngeal segment had a certain narrowing trend;3.BSSRO had more significant adverse effect on the sagittal diameter of the glossopharyngeal segment of the upper airway than the orthodontic camouflage for the treatment of adult skeletal Class ? malocclusion patients who have serious skeletal disorder and similar ANB value.